TITLE

Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung

AUTHOR(S)
Asakura, Keisuke; Izumi, Yotaro; Kohno, Mitsutomo; Ohtsuka, Takashi; Okui, Masayuki; Hashimoto, Kohei; Nakayama, Takashi; Nomori, Hiroaki
PUB. DATE
July 2011
SOURCE
European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, pe34
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Cutting the intersegmental plane by using a stapler during segmentectomy might interfere with the expansion of the preserved lung due to visceral pleura caught in a staple line, especially in a large regional segmentectomy, such as left upper division or basal segmentectomy. We compared the preserved lung volume after segmentectomy among the methods using stapler, sharp dissection, and their combination for cutting the intersegmental plane in ex vivo pig lungs. We also examined a covering effect of polyglycolic acid mesh and fibrin glue. Methods: To assume a large regional segmentectomy in clinical practice, segments of the left caudal lobe except the lateral segment 2 (L2 segment) were resected, and the lung volume of the preserved L2 segment was measured. The intersegmental plane was cut by the following three methods: (1) stapler (n =8); (2) scissors (n =8); and (3) the combined method, that is, cutting the shallow lung tissue with scissors and the deep one with stapler (n =8). The opened intersegmental plane was covered with polyglycolic acid mesh and fibrin glue. The air leakage was checked by injecting air through the bronchus at pressures of up to 30cmH2O. Thereafter, normal saline was injected through the bronchus at pressures of 10, 20, and 30cmH2O, to measure lung volumes by the volume-displacement method. Results: Polyglycolic acid mesh and fibrin glue prevented air leakage completely at up to 30cmH2O. At the saline injection pressures of 10, 20, and 30cmH2O, the mean volumes of L2 segment were 72±14, 96±14, and 109±26ml with the stapler; 86±11, 117±19, and 135±39ml with scissors; and 98±10, 140±20, and 155±40ml with the combined methods, respectively. The volume of the preserved L2 segment was significantly lower with the stapler method than with either the scissors or combined method at each pressure (p <0.01). The difference was not significant between the scissors and combined methods. Conclusions: Coverage with polyglycolic acid mesh and fibrin glue prevented air leakage from the opened intersegmental plane. The stapler interferes with the expansion of preserved lung in comparison to scissors or combined methods in a large regional segmentectomy.
ACCESSION #
61175210

 

Related Articles

  • Prospective and Randomized Comparison of Two Techniques of Staple Line Reinforcement During Open Roux-en-Y Gastric Bypass: Oversewing and Bioabsorbable Seamguard®. Salgado, Wilson; Rosa, Guilherme Vianna; Nonino-Borges, Carla Barbosa; Ceneviva, Reginaldo // Journal of Laparoendoscopic & Advanced Surgical Techniques;Sep2011, Vol. 21 Issue 7, p579 

    Aims: Surgical staple line dehiscence usually leads to severe complications. Several techniques and materials have been used to reinforce this stapling and thus reduce the related complications. The objective was to compare safety of two types of anastomotic reinforcement in open gastric bypass....

  • Semi-Automatic Quantification of Subsolid Pulmonary Nodules: Comparison with Manual Measurements. Scholten, Ernst Th.; de Hoop, Bartjan; Jacobs, Colin; van Amelsvoort-van de Vorst, Saskia; van Klaveren, Rob J.; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; de Koning, Harry J.; van der Aalst, Carlijn M.; Mali, Willem Th M.; Gietema, Hester A.; Prokop, Mathias; van Ginneken, Bram; de Jong, Pim A. // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Rationale: Accurate measurement of subsolid pulmonary nodules (SSN) is becoming increasingly important in the management of these nodules. SSNs were previously quantified with time-consuming manual measurements. The aim of the present study is to test the feasibility of semi-automatic SSNs...

  • Evaluation of fibrin sealant for biologic mesh fixation at the hiatus in a porcine model. Krpata, David; Blatnik, Jeffrey; Harth, Karem; Phillips, Melissa; Novitsky, Yuri; Rosen, Michael // Surgical Endoscopy;Nov2012, Vol. 26 Issue 11, p3120 

    Background: The ideal method to secure biologic mesh during laparoscopic hiatal hernia repair remains uncertain. Suture or tack fixation can be technically difficult, and serious cardiovascular complications have been reported. Fibrin sealant (FS) offers a potential solution to this problem. We...

  • Laparoscopic left hepatectomy in swine: a safe and feasible technique. Hua Zhang; Tao Liu; Yue Wang; Hai-feng Liu; Jian-tao Zhang; Yan-shuang Wu; Lei Lei; Hong-bin Wang // Journal of Veterinary Science;2014, Vol. 15 Issue 3, p417 

    A purely laparoscopic four-port approach was created for left hepatectomy in pigs. A polyethylene loop was placed on the left two hepatic lobes for traction and lift. Next, penetrating ligation of the lobes using of a double row of silk sutures was performed to control bleeding. A direct hepatic...

  • Experimental closure of gunshot wounds by fibrin glue with antibiotics in pigs. Djenić, Nebojša; Višnjić, Milan; Dragović, Saša; Bojanić, Vladmila; Bojanić, Zoran; Djurdjević, Dragan; Djindjić, Boris; Kostov, Miloš // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Sep2015, Vol. 72 Issue 9, p785 

    Background/Aim. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47) 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a...

  • Fibrin glue for intraperitoneal laparoscopic mesh fixation: a comparative study in a swine model. Clarke, Tatyan; Katkhouda, Namir; Mason, Rodney J.; Bon C. Cheng; Algra, Jeffrey; Olasky, Jaisa; Sohn, Helen J.; Moazzez, Ashkan; Balouch, Maryam // Surgical Endoscopy;Mar2011, Vol. 25 Issue 3, p737 

    Background: The classic method of mesh fixation in laparoscopic ventral hernia repair is transfascial sutures with tacks. This method has been associated with low recurrence rates, but yields significant morbidity from pain and bleeding. Fibrin glue has been used successfully in inguinal hernia...

  • Laparoscopic fixation of biologic mesh at the hiatus with fibrin or polyethylene glycol sealant in a porcine model. Jenkins, Eric; Lerdsirisopon, Sopon; Costello, Kevin; Melman, Lora; Greco, Suellen; Frisella, Margaret; Matthews, Brent; Deeken, Corey // Surgical Endoscopy;Oct2011, Vol. 25 Issue 10, p3405 

    Background: The objective of this study was to determine the acute and chronic fixation strengths achieved by fibrin or polyethylene glycol (PEG) sealants to secure biologic mesh at the esophageal hiatus in a porcine model. Methods: For this study, 32 female domestic pigs were divided into four...

  • Differential, time-dependent effects of perivenous application of fibrin glue on medial thickening in porcine saphenous vein grafts Wan, Song; Arifi, Ahmed A.; Chan, Michael C.W.; Yip, Johnson H.Y.; Ng, Calvin S.H.; Chow, Louis T.C.; Yim, Anthony P.C.; Jeremy, Jamie Y. // European Journal of Cardio-Thoracic Surgery;May2006, Vol. 29 Issue 5, p742 

    Abstract: Objective: Neointimal and medial thickening play a critical role in late vein graft failure following CABG. Previous ex vivo experiment suggested that perivenous application of fibrin glue may reduce the damage in the circular smooth muscle cell layer of the media of the vein graft...

  • DISCUSSION.  // American Surgeon;Jun2009, Vol. 75 Issue 6, p488 

    The article presents a discussion of the paper on postoperative leaks following laparoscopic Roux-en-Y gastric bypass (LRYGB) by Doctor Diya Alaedeen and colleagues. According to Alaedeen, consistent results were shown when endoscopy was used for insufflation. Alaedeen cites the inconsistent use...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics